Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT022614 | PA |
NPI | 1053652966 |
---|---|
Provider Name | Mr. Matthew Thomas Senese |
First Address | Warminster, PA 18974 |
Second Address | Warminster, PA 18974 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2013 |
Last Update Date | 04/03/2013 |